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August 1994

Symptomatic Choroidal Neovascularization in Blacks

Author Affiliations

From the Retina Service, Department of Ophthalmology, Emory University, Atlanta, Ga. Dr Wallace is currently with Vanderbilt University, Nashville, Tenn. Dr Meredith is currently with Retina Consultants Ltd, St Louis, Mo.

Arch Ophthalmol. 1994;112(8):1091-1097. doi:10.1001/archopht.1994.01090200097029

Objective:  To acquire descriptive clinical information regarding choroidal neovascularization (CNV) in black Americans.

Design:  Retrospective review of 1308 fluorescein angiograms obtained during a 4-year interval. Color photographs and clinical records of all black patients with angiographically apparent CNV were subsequently reviewed.

Setting:  Retina service of an inner-city county hospital in Atlanta, Ga, serving a predominantly black population.

Results:  Thirty blacks with CNV (36 of 59 eyes) were identified, 26 (87%) of whom were female. Active, exudative neovascularization was present in at least one eye of 21 patients (70%). Patients were assigned to one of four diagnostic groups for analysis. Group 1 was made up of 13 patients (43%) with age-related macular degeneration with CNV. Women outnumbered men 5.5:1. Choroidal neovascularization was peripapillary in seven (54%) of these 13 patients. Group 2 was made up of six patients (20%) with idiopathic CNV, which was peripapillary in all eyes. Group 3 consisted of three women (10%) with idiopathic polypoidal choroidal vasculopathy. Group 4 was composed of eight patients (27%) with secondary CNV. The CNV was peripapillary in three (33%) of nine eyes, and women outnumbered men 7:1.

Conclusions:  The spectrum of neovascular maculopathy in blacks in the current study differed from that typically seen in whites, both clinically and demographically. Clinically, CNV was most commonly juxtapapillary (13 [68%] of 19 patients) and unilateral (12[92%] of 13 patients) among the age-related macular degeneration and idiopathic groups, while six (20%) of 30 patients (all older than 50 years) had CNV in the absence of drusen or other known predisposing conditions. Disciform-stage CNV in both groups was associated with a greater degree of pigment proliferation than that typically noted in whites. Demographically, female predominance (87% overall) was dramatic compared with prior studies.

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